119 articles - From Saturday Mar 26 2022 to Friday Apr 01 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
Diagnosis and Management of Barrett's Esophagus: An Updated ACG Guideline. We recommend endoscopic eradication therapy for patients with BE and high-grade dysplasia and those with BE and low-grade dysplasia. We propose structured surveillance intervals for patients with dysplastic BE after successful ablation based on the baseline degree of dysplasia. We could not make recommendations regarding chemoprevention or use of biomarkers in routine practice due to insufficient data. |
| Gastroenterology |
AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review. BEST PRACTICE ADVICE 7: The low-FODMAP diet consists of the following 3 phases: 1) restriction (lasting no more than 4-6 weeks), 2) reintroduction of FODMAP foods, and 3) personalization based on results from reintroduction. BEST PRACTICE ADVICE 8: Although observational studies found that most patients with IBS improve with a gluten-free diet, randomized controlled trials have yielded mixed results. BEST PRACTICE ADVICE 9: There are limited data showing that selected biomarkers can predict response to diet interventions in patients with IBS, but there is insufficient evidence to support their routine use in clinical practice. |
Rio de Janeiro Global Consensus on Landmarks, Definitions and Classifications in Barrett's Esophagus: World Endoscopy Organization Delphi Study. We have developed evidence-based consensus-driven statements on endoscopic landmarks, definitions, and classifications of BE. These recommendations may facilitate global uniform reporting in BE. |
| Gastrointest Endosc |
Adherence to follow-up guidelines after high-risk colorectal polyp removal: a population-based study. Adherence to follow-up guidelines was poor inappropriate intervals were more often longer than recommended. Patients with written follow-up instructions and who underwent their follow-up colonoscopy mostly followed these instructions. Ensuring adherence to guidelines and giving written instructions to patients should be primary goals to achieve effective follow-up. Gastroenterologists' training should be improved in this way. |
| Hepatology |
Consensus subtypes of hepatocellular carcinoma associated with clinical outcomes and genomic phenotypes. Five HCC subtypes are correlated with genomic phenotypes and clinical outcomes and highly conserved in pre-clinical models, providing a framework for selecting the most appropriate models for preclinical studies. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Systematic review and meta-analysis: incidence of variceal hemorrhage in patients with cirrhosis undergoing transesophageal echocardiography. The risk of bleeding complications following TEE is low in patients with cirrhosis, suggesting TEE is safe and risk stratification with upper endoscopy may not be necessary. |
| Neurogastroenterol Motil |
Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review. As observed in this systematic review, MRI is a flexible tool for assessing GE. Different protocols were analyzed, showing an equal capacity to assess the GE. However, many items in these protocols still require further investigation to obtain a common standard and increase this assessment quality. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
The effect of gluten in adolescents and young adults with gastrointestinal symptoms: A blinded randomised cross-over trial. Compared with placebo, adding gluten to the diet did not induce gastrointestinal symptoms or worsened mental health in adolescents recruited from a population-based cohort. The trial registration |
Toward transmural healing: Sonographic healing is associated with improved long-term outcomes in patients with Crohn's disease. In patients with CD in clinical remission, sonographic healing is associated with improved clinical outcomes. Further studies are needed to determine whether sonographic healing should be a treatment target. |
| Am J Gastroenterol |
Burden of Constipation: Looking Beyond Bowel Movements. For those who seek help, only one-fifth feel that their constipation symptoms are well managed. Notable sex and cultural differences exist regarding individuals consulting their HCP about constipation. Many individuals with CIC and IBS-C remain inadequately managed and unduly affected, contributing to the high social and economic burden of these conditions. |
Effect of chronic comorbidities on follow-up colonoscopy after positive colorectal cancer screening results: a population-based cohort study. Persons with medical and mental health conditions had lower colonoscopy rates after FOBT+ than those without these conditions. Better strategies are needed to optimize colorectal cancer screening and follow-up in individuals with comorbidities. |
Effective Communication Strategies and Tools for Improving Treatment Outcomes in Patients With Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation. Currently, there are multiple symptom and quality-of-life scales available to assist healthcare providers in this endeavor. These scales also allow for the monitoring of constipation-related symptoms and symptom severity. When using patient self-assessments to measure treatment responses, scale selection may depend on the number of symptoms being assessed, the duration and frequency of assessments, and patients' comprehension and language skills. |
Individuals with eosinophilic esophagitis are at greater risk of later psychiatric disorder. Individuals with EoE may be at greater risk of psychiatric disease than their siblings and the general population. This risk needs to be considered in clinical care to detect, prevent, and treat comorbidity. |
Large Hepatic Adenomas and Hepatic Adenomatosis: A multicenter study of risk factors, interventions, and complications. In this large HCA cohort, obesity and metabolic comorbidities were important risk factors associated with large HCA and adenomatosis. Long term adverse outcomes were infrequent, 5% had tumor hemorrhage and one exhibited malignant transformation. |
Lung infection impacts access to treatment and short-term outcome in patients with severe alcohol-related hepatitis treated with corticosteroids. Lung infection is frequent during severe AH and influences mortality at admission and after steroid initiation. These results emphasize the need for specific management of lung infection during the course of AH. |
Mechanisms of Action of Current Pharmacologic Options for the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation. Some constipation treatments, such as stimulant laxatives, may increase bowel movement frequency but are ineffective at relieving, and may even exacerbate, abdominal symptoms. On the contrary, prescription treatments, such as the guanylyl cyclase-C agonists, for example, may improve bowel symptoms and reduce visceral hypersensitivity. This review summarizes the mechanisms of action of commonly used over-the-counter and prescription therapies for chronic idiopathic constipation and irritable bowel syndrome with constipation, outlining how these mechanisms contribute to the efficacy and safety of each treatment option. |
Percutaneous Tibial Nerve Stimulation vs Sham Stimulation for Fecal Incontinence in Women: NeurOmodulaTion for Accidental Bowel Leakage Randomized Clinical Trial. Although symptom reduction after 12 weeks of PTNS met a threshold of clinical importance, it did not differ from sham stimulation. These data do not support the use of PTNS as conducted for the treatment of FI in women. |
Real-World Treatment Strategies to Improve Outcomes in Patients With Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation. Should initial prescription treatments fail, retrying past treatment options (if not adequately trialed initially), combining agents from alternative classes, or use of adjunctive therapies may be considered. Given the broad spectrum of available agents, therapy should be tailored by mutual decision-making between the patient and practitioner. Overall, patients need to be actively monitored and managed to maximize clinical outcomes. |
| Clin Gastroenterol Hepatol |
An Office-Based, Point-Of-Care Test Predicts Treatment Outcomes with Community-Based Pelvic Floor Physical Therapy in Patients with Chronic Constipation. RED offers an opportunity to disrupt the paradigm by offering a personalized approach to managing chronic constipation in the community.([NCT04159350]). |
Are they side effects? Extra-intestinal symptoms reported during clinical trials of IBS may be more severe at baseline. Our study suggests that participants with IBS often experience extra-intestinal symptoms at baseline and that these symptoms generally improve in severity over the course of a clinical trial, regardless of the treatment arm. Systematic assessment of extra-intestinal symptoms at the beginning of a clinical trial is necessary to determine more definitively whether these symptoms may be considered an adverse event attributable to a study medication. |
Low Daily Step Count is Associated with a High Risk of Hospital Admission and Death in Community-Dwelling Patients with Cirrhosis. Daily step count predicted hospital admission and mortality rates in patients with cirrhosis, similar to the current standard frailty metrics. Incorporation of a physical training-dedicated smartphone application was associated with increased PAT usage and steps reporting. |
Polygenic risk score for defining personalized surveillance intervals after adenoma detection and removal at colonoscopy. Consideration of genetic predisposition to CRC risk, as determined by a PRS, could help to define personalized, risk-adapted surveillance intervals after detection and removal of adenomas at screening colonoscopy. However, whether the risk variation is strong enough to direct clinical risk stratification needs to be further explored. |
redicting the onset of hepatitis B virus-related acute-on-chronic liver failure. A new prognostic score based on 4 predictors can accurately predict the 7/14/28-day onset of ACLF in patients with acute deterioration of HBV-related chronic liver disease and might be used to guide clinical management. |
The natural history of advanced chronic liver disease defined by transient elastography. Liver stiffness, ALBI score, and disease aetiology are each associated with outcomes in a large contemporary cohort with ACLD. EHR data can be used to define clinical progression in these patients, facilitating large clinical effectiveness trials and cost-effectiveness analyses. |
| Endoscopy |
Rate of pancreatic cancer following a negative endoscopic ultrasound and associated factors. PEPC was associated with a higher cumulative mortality at 1 year (hazard ratio 1.12, 95 |
| Gastroenterology |
Relative Contribution of Disease Activity and Psychological Health to Prognosis of Inflammatory Bowel Disease During 6.5 years of Longitudinal Follow-up. Psychological factors are important determinants of poor prognostic outcomes in IBD and should be considered as a therapeutic target. |
| Gastrointest Endosc |
Assessment of post-manual cleaning adenosine triphosphate tests to prevent the use of contaminated duodenoscopes and linear echoendoscopes: the DETECT study. Post-manual cleaning ATP tests do not reduce post-HLD gut flora contamination rates of DLE. Hence, post-cleaning ATP tests are not suited as a means for quality control of endoscope reprocessing. |
| Hepatology |
ATP7B gene therapy of autologous reprogrammed hepatocytes alleviates copper accumulation in a murine model of Wilson's disease. We established a novel system of autologous reprogrammed WD hepatocytes and achieved ATP7B gene therapy in vitro. LPC-ATP7B-Heps transplantation demonstrated therapeutic efficacy on copper homeostasis in a murine model of WD. |
Bile multi-omics analysis classifies lipid species and microbial peptides predictive of Carcinoma of Gall bladder. Bile sample of CAGB patients show significant reduction in lipid species and increase in bacterial taxa. Our study identifies a core set of bile lipidome and meta-proteome signature which may offer universal utility for early diagnosis of gall-bladder carcinoma. |
Cellular heterogeneity and transcriptomic profiles during intrahepatic cholangiocarcinoma initiation and progression. Stress-responding and ICC proliferating subtypes were identified, and Zmiz1 and Ybx1 were revealed as core transcription factors in these subtypes. Fibroblast-endothelial cell interaction promotes ICC development. |
Malignant progression of liver cancer progenitors requires KAT7-acetylated and cytoplasm-translocated G-protein GaS. Malignant progression of HcPCs requires increased K28-acetylated and cytoplasm-translocated GaS, causing enhanced response to IL-6 and driving premalignant HcPCs to fully established HCC, which provides mechanistic insight and potential target for preventing hepatocarcinogenesis. |
PNPLA3 rs738409 and Risk of Fibrosis in NAFLD: Exploring Mediation Pathways Through Intermediate Histological Features. In NAFLD, nearly half of the total effect of the rs738409 G allele on fibrosis severity could be explained by a direct pathway, suggesting that rs738409 may promote fibrosis development by activating specific fibrogenic pathways. A large proportion of the indirect effect of rs738409 on fibrosis severity is mediated through portal inflammation. |
Reliability of extracellular contrast vs. gadoxetic acid in assessing small liver lesions using LI-RADS v.2018 and EASL criteria. Agreement for definite hepatocellular carcinoma was substantial and similar for both scoring systems and the two contrast agents in small focal liver lesions. The agreement for LI-RADS categorization was lower for both contrast agents, and including LI-RADS ancillary features did not improve the agreement. |
Reliability of Histologic Assessment for NAFLD and Development of an Expanded NAFLD Activity Score. After extensive preparation among a group of experienced pathologists, we demonstrated improved reliability of multiple existing histologic NAFLD indices and fibrosis staging systems. Hepatocyte ballooning and MDBs most strongly correlated with disease activity and were used for the new expanded NAS. Further validation including evaluation of responsiveness is required. |
Risk of liver-related events by age and diabetes duration in diabetic patients with non-alcoholic fatty liver disease. Age rather than duration of T2D predicts liver-related events in NAFLD patients with T2D. It is reasonable to screen NAFLD patients with T2D for advanced liver disease starting at 50 years of age. |
Variability in Serum Creatinine is Associated with Waitlist and Post-Liver Transplant Mortality in Cirrhosis Patients. This study informs the long-term impact of the variation in kidney function we al see in clinic practice. These data highlight that al fluctuations in sCr are associated with worse pre-and post-liver transplant outcomes. |
| Inflamm Bowel Dis |
Vedolizumab Antagonizes MAdCAM-1-Dependent Human Placental Cytotrophoblast Adhesion and Invasion In Vitro. This study revealed a previously unrecognized role for a4ß7 and MAdCAM-1 in human placentation. More clinical and histological data from Vedolizumab-treated pregnant patients will be necessary to determine whether this medication poses any risk to the mother and fetus. |
| J Crohns Colitis |
Cellular and humoral immune responses to SARS-CoV-2 vaccination in inflammatory bowel disease patients. In vaccinees with low or borderline IGRA, treatment with TNF-alpha inhibitors was the most frequent. In individuals with a significant drop in anti-spike antibody levels, plasmatic interferon-gamma concentrations after the specific SARS-CoV-2 stimulation were also insufficient. Simple humoral and cellular post-vaccination monitoring is advisable in IBD patients so that repeated vaccine doses may be scheduled. |
IL10 secretion endows intestinal human iNKT cells with regulatory functions towards pathogenic T lymphocytes. Moreover, an intestinal microbial community enriched in SCFA-producing bacteria sustained the production of IL10 by iNKT cells. Finally, IL10- deficient iNKT cell failed to control the pathogenic activity of adoptively transferred CD4+ T cells in an experimental colitis model. These results describe an unprecedent IL10-mediated immunoregulatory role of intestinal iNKT cells in controlling the pathogenic functions of mucosal T-helper subsets and in maintaining the intestinal immune homeostasis. |
Safety of Recombinant Zoster Vaccine in Patients with Inflammatory Bowel Disease. In a nationwide cohort of stable IBD patients, administration of RZV was not associated with the risk of IBD flare within 90 days. These findings should motivate further usage of this highly effective vaccine. |
| J Hepatol |
Endoplasmic reticulum-mitochondria miscommunication is an early and causal trigger of hepatic insulin resistance and steatosis. The literature suggests that interactions between endoplasmic reticulum (ER) and mitochondria could play a dual role in hepatic insulin resistance and steatosis during chronic obesity. The present study reappraised time-dependent regulation of hepatic ER-mitochondria interactions and calcium exchange in diet-induced obese mice and their causal role in hepatic insulin resistance and steatosis. We show that organelle miscommunication is an early causal trigger of hepatic insulin resistance and steatosis, and can be improved by nutritional strategies. |
Unique molecular characteristics of NAFLD-associated liver cancer accentuate ß-catenin/TNFRSF19-mediated immune evasion. The unique mutational processes in NAFLD-liver and NAFLD-HCC alludes to a "field effect". Whereby, distinct aberrations and shift in driver events reveal a gain-of-function role of CTNNB1 mutations in immune exclusion via TNFRSF19 inhibition of SASP-like features. |
| Neurogastroenterol Motil |
A double-blind randomized, multicenter, placebo-controlled study of itopride in functional dyspepsia postprandial distress syndrome. Using the LPDS score in a pilot controlled trial in FD, itopride shows no therapeutic benefit over placebo after 8 weeks of treatment. In an exploratory post hoc analysis, itopride but not placebo was associated with improvement of symptoms compared to baseline, and this was most prominent in patients with overlapping PDS/EPS. The efficacy of itopride in this subgroup needs to be evaluated in a large study using the same outcome measure. (clinialtrials.org ref. NCT04647955). |
Health-care resource use and costs associated with diabetic and idiopathic gastroparesis: A claims analysis of the first 3 years following the diagnosis of gastroparesis. The economic burden of gastroparesis remains high several years after diagnosis, emphasizing the need for chronic treatment to effectively manage symptoms and consequently reduce the burden of this disorder. |
Peripheral and central pathophysiological changes in a new rat model of acid reflux combined with mental stress. Mental stress and acid reflux affect GERD through peripheral and central aspects, which can result in the poor efficacy of acid inhibitors. This may provide a new direction for the treatment of GERD. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Gastroenterology |
| Hepatology |
Circulating hepatitis B virus RNA: From biology to clinical applications. Specifically, we summarized the reported species and existing forms of circulating HBV RNA and discussed their biogenesis and the capacity of de novo infection by RNA virions. Moreover, we described the potential applications of circulating HBV RNA in different clinical scenarios, such as classifying the phases of chronic HBV infection, analyzing sustained on-treatment and off-treatment outcomes of treated patients, as well as predicting hepatocellular carcinoma development. Perspectives on future research of circulating HBV RNA were also proposed in this review. |
| Inflamm Bowel Dis |
| J Hepatol |
Heretical thoughts into Hepatic Encephalopathy. Many lines of investigation have confirmed that hepatic encephalopathy is irreversible in many patients and suggests the need for further studies focussing on mechanisms of neuronal injury and death to guide future drug development for these patients. The clinical evidence behind using lactulose for al severities of hepatic encephalopathy, which is currently considered the standard of care is poor and placebo-controlled trials for hepatic encephalopathy should be considered ethically sound. This expert opinion identifies current challenges in hepatic encephalopathy and highlights areas which require further debate and investigation in order to help advance the field both scientifically and clinically. |
| Neurogastroenterol Motil |
Role of inflammation in pediatric irritable bowel syndrome. Likewise, the development of long-standing GI symptoms fulfilling the current criteria for functional GI disorders after infection gastroenteritis and in patients with IBD or celiac disease in remission further supports this hypothesis. Immune activation, its impact on gut sensory-motor function, and potential implications for symptom generation emerged in both children and adults with IBS. Purpose The aim of this review is to summarize the main evidence on the presence of low-grade inflammation and immune activation in children with IBS, its possible role in symptom generation, and its potential implication for new therapeutic strategies. |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Inflamm Bowel Dis |
| J Hepatol |